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Enthesopathies are changes in the attachment of tendons to the bones of an overload-degenerative nature. They are very common due to the fact that they are favored by many activities typical of the inhabitants of Western civilization. Fortunately, modern medicine has a wide range of methods of treating this ailment.
What is enthesopathy and what causes it?
Enthesopathy is associated with overloading the muscle tendons. As a result of excessive load, microtraumas occur not only in the muscles and tendons, as is commonly believed, but also in the area of cartilage that connects the tendons with the bone. The essence of enthesopathy is the inflammation that develops at that time, which causes pain and discomfort, and also weakens the structure of the cartilage. Untreated enthesopathy can then lead to a more serious injury, such as detachment of the tendon from the bone.
Excessive stress on tendon attachments may arise as a result of congenital defects in the structure of the musculoskeletal system or other acquired ones. Most often, however, they are the result of everyday physical activity: doing sports, especially professionally, incorrect or completely omitted warm-up before training or physical work. It is worth knowing that working in front of a computer can also be associated with overload, especially in the area of the wrist, if the ergonomic position at the desk is not maintained.
What are the different types of enthesopathy?
Enthesopathy is not a single disease entity – professionally speaking, it is a group of lesions called enthesopathies. It can occur in various joints in the human body. The most common enthesopathies include:
- de Quervain’s syndrome – inflammation of the extensor tendon sheath,
- tennis elbow, i.e. inflammation in the area of the lateral epicondyle,
- Jumper’s knee – knee enthesopathy, specifically the ligaments of the patella,
- shoulder enthesopathy,
- quadriceps enthesopathy.
Note: Sports-related names for enthesopathy are commonplace and do not imply that only athletes in the field are affected by the condition. In practice, it turns out that similar overloads also arise as a result of other activities.
What is enthesopathy manifested?
Symptoms of deterioration in the quality of tendon work are usually quite characteristic. Regardless of the place of occurrence, we should pay attention to such signals as:
- sharp and stabbing pain that radiates to the surrounding area, occurring mainly at the time of exertion or immediately after,
- swelling and tenderness within the affected joint. It is possible that the inflamed tendon thickening will be felt under the skin.
- the feeling of “escaping” the pond, crackling,
- reduced efficiency of the joint – difficulty in achieving the full range of mobility, less precision in manual activities (with changes in the hand and wrists) or problems with walking, sitting, inserting, etc. in lower limb enthesopathies.
These are symptoms that cannot be underestimated. Untreated enthesopathies worsen and can lead to irreversible or very difficult to treat changes.
How is enthesopathy treated?
The first step in treating enthesopathy is diagnosis. The doctor first conducts an interview with the patient and then tries to feel the characteristic swelling and thickening under his fingers. Usually, to be sure, an ultrasound is ordered, which allows you to assess the degree of cartilage loss and the presence of any lumps and adhesions.
If the diagnosis is confirmed, conservative treatment in the form of cold compresses, administration of painkillers and anti-inflammatory drugs, as well as immobilization of the joint is recommended in the first place. However, this is only sufficient in the lightest cases. Typically, doctors refer the patient to physical therapy, which is aimed at reducing discomfort, reducing inflammation, and stimulating damaged tissues to regenerate. The most commonly used methods include:
- massages,
- cryotherapy,
- iontophoresis,
- magnetotherapy,
- ultrasound therapy,
- laser therapy.
If the damage to the attachments is very extensive, surgery may be necessary. Regardless of the degree of enthesopathy development, a very important element of recovery is proper exercise, aimed at strengthening the muscles and reducing dangerous tensions. In the case of enthesopathy, for example hip or knee exercises, exercise may be a necessary condition for recovery.